Insurers, reinsurers and mutual insurers

It depends on the form of the contract. An individual contract can in principle be changed only by an amendment the policyholder accepts. In a group insurance contract⁠, the policyholder (an association or an employer) signs the amendment and informs members in writing at least three months before it takes effect; where the policyholder is a savers’ association, its general meeting must authorise it. The change is enforceable against policyholders and members only if this procedure is followed.

You must check the national register of natural persons (RNIPP) at least annually for deaths among your insured persons, then trace beneficiaries. Since 2016, the Eckert Act has also required the capital to be revalued after death and, failing a claim within the statutory period, transferred to the Caisse des dépôts (a French public financial institution). The ACPR checks this work on unclaimed (dormant) contracts and has already sanctioned failures. Keep evidence: search dates, letters to beneficiaries, revaluation workings.

On two conditions set by the Code des assurances (the French Insurance Code): they must be formal and limited (Article L. 113-1), and appear in very conspicuous characters (Article L. 112-4). The courts disregard an exclusion that calls for interpretation, or that deprives the cover of its substance. In borrower (creditor) insurance or key person insurance⁠, disputes also turn on how claims are defined and on the statements made on joining: review these clauses together, before the product is marketed.

For those of your agents, yes: the Code des assurances makes you civilly liable for them, notwithstanding any agreement to the contrary (Article L. 511-1). A broker in principle acts for its client, but a delegation of premium collection or administration, or an appearance of authority you have allowed to develop, can bind you. Your distribution agreement should therefore allocate the tasks, and your controls should demonstrate that it does.

Several, with very different effects. A merger or a total portfolio transfer ends the mutual insurer’s own business, whereas joining a mutual group union (union mutualiste de groupe) or a mutual insurance group company (société de groupe d’assurance mutuelle, SGAM) preserves it, with ties of financial solidarity. The choice affects governance, own funds, in-force contracts and reinsurance treaties. It involves the general meeting and, depending on the transaction, the ACPR.

In principle, and unless the reinsurance treaty provides otherwise, the reinsurer follows the fortunes of the ceding insurer: a settlement made in good faith, for a covered risk, is as a rule binding on it. It can, however, challenge a settlement that concerns a risk excluded from the treaty, or that was reached in breach of a claims cooperation or claims control clause. These clauses are negotiated when the treaty is placed, then applied case by case.